The Brand Name EMZOLAM Has Generic Salt :: TEMOZOLOMIDE 

EMZOLAM  Is From Company MIRACALUS Priced :: Rs. 8526.00/20391.00

EMZOLAM have TEMOZOLOMIDE is comes under Sub class Anti Neoplastic Agents of  Main Class Anti Neoplastic Agents

Main Medicine Class:: Anti Neoplastic Agents  Sub Medicine Class :: Anti Neoplastic Agents 

Indications for Drugs ::

Glioblastoma multiforme, Malignant gliomas, Metastatic melanoma

Drug Dose ::

Adult: PO Glioblastoma multiforme Concomitant phase: 75 mg/m2 once daily for 42 days w/ focal radiotherapy. Initiate monotherapy 4 wk after completing concomitant phase: 150 mg/m2 once daily for 5 days followed by a 23 day break (1 cycle). Cycle 2: 200 mg/m2 once daily for 5 days. If dose cannot be increased in cycle 2, do not increase dose in subsequent cycles. Dose used in cycle 2 is given for the rest of the cycles, toxicity allowing, up to 6 cycles. Recurrent or progressive malignant gliomas Chemotherapy naive: 200 mg/m2 once daily for 5 days, followed by a 23 day break (1 cycle). Chemotherapy-experienced: 150 mg/m2/day for 5 days followed by 23 day break (1 cycle), increased to 200 mg/m2/day for the 2nd cycle if there is no haematological toxicity. Child: >3 yr: Previously untreated with chemotherapy: 200 mg/m2 once daily for 5 days, followed by a 23 day break (1 cycle). Previously treated with chemotherapy: 150 mg/m2 daily for 5 days followed by 23 day break (1 cycle) increased to 200 mg/m2 for the 2nd cycle if there is no haematological toxicity. Metastatic melanoma 200 mg/m2/day for 5 days every 28 days.

Contraindication ::

Hypersensitivity to dacarbazine. Severe myelosupression. Pregnancy.

Drug Precautions ::

Severe hepatic and renal impairment. Elderly >70 yr, children. Women of child bearing potential should avoid becoming pregnant during therapy. Males should be advised not to father a child up to 6 mth after treatment and to consider cryoconservation of sperms due to possibility of irreversible infertility. Unknown if distributed into breastmilk, discontinue nursing due to potential risk. May impair ability to drive or operate machinery. Swallow capsules whole with a full glass of water on an empty stomach or at bedtime. Do not take a 2nd dose if capsules are vomited. Monitor CBC wkly during concomitant therapy and on day 22 of each 28 day treatment cycle, followed by wkly blood count until recovery. Hepatitis screening and prophylactic therapy with antiviral agents as clinically indicated to be considered. Prophylaxis for Pneumocystis jiroveci (or Pneumocystis carinii) pneumonia (PCP) needed for all patients receiving concomitant temozolomide and radiation therapy for the 42-day regimen; if patients experience lymphocytopenia during the concomitant phase of therapy, PCP prophylaxis should be continued until recovery from lymphocytopenia. Monitor closely for PCP development in all patients. Anti-emetic prophylaxis recommended.

Drug Side Effects ::

Nausea, vomiting, taste perversion, constipation, diarrhoea, abdominal pain, stomatitis, anorexia, headache, fatigue, convulsions, dizziness, memory impairment, impaired concentration, tremors, blurred vision, hearing impairment, speech disorder, rash, infection, oral candidiasis, dyspnoea, coughing, neutropenia, thrombocytopenia, leucopenia, anaemia, hyperglycemia, decreased wt, insomnia, anxiety, alopecia, muscle weakness, urinary incontinence, increased alanine aminotransferase. Rarely, myelodysplastic syndrome and secondary malignancies.

Pregnancy category ::

4

Drug Mode of Action ::  

Temozolomide, a triazene, is an inactive prodrug. It is chemically hydrolysed to 3-methyl-(triazen-1-yl) imidazole-4-carboxamide (MTIC), the active metabolite of dacarbazine. The cytotoxicity of MTIC is believed to be due alkylation of DNA, mainly at the O6 and N7 positions of guanine.

Drug Interactions ::

Valproic acid, other myelosuppressive agents.